I'm still trying to get a better understanding of the principl of double-effect and I have two follow-up questions.

As you said, "The short answer to your question is no, there are not any instances where such an act is justified" when I asked, "can there be an instance where a mother's life is in danger while she is four or five months pregnant and a doctor can morally and ethically induce labor knowing full well the baby will not survive?"

I totally understand, as the doctor pointed out in your reference, "that direct abortion is not medically necessary to save the life of a woman" and that there "is a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child" and "that the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women."

What I was asking about was not aborting a child 4 or 5 months into the pregnancy (that's always evil), but rather delivering without intend to kill the child when the child is too premature to survive but yet the mother's life is in danger. I want to make sure I am clear on what I am arguing when defending life so I hope you don't mind my asking this more explicitly. So my first question is:

1) When a pregnant woman's obstetrician is caring for both the mother and the unborn baby at a point where if delivered the child is not expected to survive but yet complication arise that threaten the mother's life, can the doctor deliver the child by inducing labor or performing a Caesarian section at 4 or 5 months into the pregnancy and the doctors intention is still to save the life of both the mother and the baby even though the child is too premature and will most likely not survive? I am not asking about willfully destroying the baby because the mother's life is in danger.

Also,
2) Can you give me some examples to use where there might be instances other than tubal pregnancies where the principle of double-effect would apply?

Thanks for all your help and God Bless you and all your work.

Answer by Judie Brown on 9/17/2012:

Dear Anonymous

If a physician delivers a baby prematurely with the understanding that the baby he is
delivering cannot survive, then he is accepting the fact that his action will result in
the child dying. To my mind the intent is questionable and if he argues that he does
not intend to kill the child, but rather realizes that the child will die, I see no moral
difference. He is aware of the results of his action if he takes the planned action no
matter what he calls it.

1) The answer to your first question then is that splitting hairs about how the doctor
feels about the known result of his action is not the point; the point is that if he does
not deliver the baby early and treats both patients as best he can then at least he has
used his skills to save life, not act with an expectation that one will die.

2) If an expectant mother is experiencing an ectopic pregnancy and the fallopian
tube becomes inflamed, then infection has likely set in and the doctor must remove
that section of the tube that is infected or the mother will die. His intention is not to
kill the embryo lodged in the tube but to save the mother's life. The unintended
result is the death of the child who, due to the infection, may already be dead.